Tuesday, May 06, 2008

Back in the Saddle

I must be crazy. Why else would I purposely subject myself to having to get up in the morning again, to take a shower by the ungodly hour of 8 a.m., so I can get my creaky aching bones to the office by 9? Oh yeah; I’m most definitely certifiable.

Or maybe I’m just an idiot. Why else would I start in again with helping veterans try to deal with the seeming indifference of the local VA office and its officious band of raters, examiners, adjudicators, reviewers, and managers? Epiphany! I’m crazy AND an idiot!

You know what’s amazing? The copious verbiage that seems to spout from the embassy’s third VA floor as if from a busted fire hydrant. The scary thing is that I am able to understand much of what they spurt.

“My veterans,” many almost mad with anxiety, with these infuriating letters in hand, some crumpled up earlier in a fit of rage before being smoothed back into a semi-readable form, line up, hoping that I’ll be the one to bring some sense to the maddening words and turn their panic to some semblance of peace of mind.

When it’s their turn they’ll sit next to me at our little round conference table, usually with a deep sighing groan, hand over their well-worn letters, and gaze anxiously at me with a hint of desperation as I push my reading glasses up my nose and start to read. Usually, before I can finish even a single sentence, they’ll start to squawk and carry on. I give them a “I know, I know. They’re evil, but let me read this so I can figure out what to do next, okay?”

Much of what I do is interpret. Sometimes my guys will look at me expectantly like I’m some kind of archeologist reading ancient cuneiform tablets or Egyptian hieroglyphics, just waiting for me to jump up and scream “Yes! It’s all making sense!” I have to admit that it makes me feel somewhat superior that I am able to decipher what they, simple vets straight “off the street,” without my years of training and experience, are clueless to understand, at least as far as knowing “what to do next.”

It’s not that the stuff is written in something other than English; no, it’s nothing like that. The irony is that basically the VA, in trying to fulfill a mandate to keep claimants “informed,” tends to drown them in too much information.

So here’s some of what’s happening. The VA is SUPPOSED to inform each veteran on EXACTLY what they’ll need to fulfill the requirements of “reasonable doubt” proof that would cause VA adjudicators to approve their claim. Instead, they simply tell veterans to provide nebulous “medical evidence” that “shows the condition was treated from the end of their military service to the present.”

My answer to that: Hey VA, THAT is a crock! Most folks that suffer from service related conditions simply do what they mostly did while they were on active duty—they suck it up and keep on trucking, and most often, out of necessity, they self-medicate. Now, if you leave it to the VA, that’s as far as most claims would go—straight into the VA denial waste bin, because almost no one would be able to provide that sort of continuum of medical treatment evidence. It’s unreasonable to expect otherwise.

What they don’t mention is that a medical opinion by the veteran’s physician simply stating that, “based on assessment of service medical records, the veteran’s present condition “more likely than not” began in service” is all that SHOULD be needed to provide connection proof to service. Sounds simple enough right? Yet, do you think that simple instructive statement ever finds its way into a “duty to assist and inform” template paragraph in any VA letter to a veteran claimant? That’s a rhetorical question by the way.

The mistake a lot of veterans make, at least from what I’ve seen at the “local version” of the VA, is to provide to the VA feasible “starter evidence” that results in the claimant being sent to VA physician examiners. These “impartial” (Yeah RIGHT!) VA doctors are then instructed to “examine by worksheet” the claimant, after which the rating side of the VA house asks these same doctors to provide a medical opinion as to whether or not the veteran’s condition is related to service.

Here’s a typical “open-minded” VA medical proclamation resulting from one of these inquiries: “It is less likely than it is that the veteran’s condition is service connected.”

Let me interpret that for you: “The chances that the veteran’s condition is connected to service is just less than 50-50.”

Keep this in mind; if they’d nudged it up ever so slightly to a shade just better than 50-50, then the VA would HAVE to grant service connection. So, to counter this VA mealy-mouthed tendency to “err on the side of denial” I’ve found it best to advise “my people” to go to their OWN private physician for a “better than 50-50” opinion, one that is EVER so close to the VA’s almost inevitable “less than 50-50” one. By getting this precious piece of paper from their own doctor it makes the VA's anti-opinion moot since the two disagreeing opinions cause "equipoise," and the beauty of the system is that "the tie goes to the runner," to use baseball terminology.

Is this stuff making your head spin? Hell, by now, most anyone trying to read this stuff has probably already given up; and I wouldn’t blame them one bit. Am I sounding cynical? Hey, call me a cynic.

However, I AM hopeful that change is in the wind. Today was my third day back in the saddle, but during the weekend I read over about 50 or so VA letters to “my veterans.” Mind you, the VA sends us copies of all correspondence sent to claimants, so long as they signed up with us to represent them.

So what has me hopeful is that many of the decisions actually seemed fair. Also, even more encouraging, is that several recent decisions seemed to result from some “intelligent oversight,” because the decisions made by these “beings” were actually overturned old denial decisions. When I saw these award letters I could not believe my eyes, since in my previous tour of duty, which comprised almost 4 years, I don’t remember even one such reversal in favor of a veteran.

So, something is definitely happening over there. I just hope it continues, because it bodes well for my people. Geez, I sound like freaking Moses!


Anonymous said...

Lots of hugs boy!

I am so damn proud of you.

PhilippinesPhil said...

Ah shucks. Tanks Mom!

KA said...

lol dont u just love how hope is lol.

Ed said...

It seems as if the medical industry for the military is similar to that for the civilians. Full of lots of red tape and bureaucracy.

Anonymous said...

For those still on active duty, start documenting your illnesses by going to your doctor(s). You have to outsmart the smart ass people. Don't be a macho who suck it up, I wasn't.
You deserve to be compensated!

Amadeo said...


I believe that is how it is in life. Some are designed or are deigned to take it in the chin. Still, we wonder, why us?

I made a similar comment the other day to an old friend that some people believe we owe them a living and so assume that expectation. And maybe for love of pain or suffering, or simply because turning away requires so much, we do it anyway or allow them to.

But more power to you!

Anonymous said...

Okay...yes...I am wondering about a new post...Ha. Get to it boy!

PhilippinesPhil said...

Ha, you're trying to get me to comment on the flap this one has already caused, what with the VARO Manila director himself sending out an email to folks that he thought might be able to reign me in. I have to admit; he caused quite a stir; and truth be known, I am tickled slightly by it. If you read my stuff again Jon, just remember, all I do is make observations; I don't make any of this stuff up.

Hope, my next post is going to be about a Marine I met the other day. What a gem!

Anonymous said...

I know. I know. That was what I was waiting for--that awesome vet you were talking about helping. THose other folks too slow to realize what they have in you are of no consequence to me boy. sounds like things turned out as they should have and you can get back to doing the impotant things with your time...ie that awesome vet.